The human gut mycobiome and the specific role of Candida albicans: where do we stand, as clinicians?

The so-called “mycobiome” has progressively acquired interest and increased the complexity of the understanding of the human gut microbiota. Several questions are arising concerning the role of fungi (and in particular of Candida albicans), the so-called “mycobiome”, that has been neglected for a long time and only recently have gained interest within the scientific community. As of today, there is no consensus on mycobiome normobiosis due to its instability and variability. This review aims to raise awareness about this interesting topic and provide a framework for guiding physicians faced with such question.
To summarize current knowledge and discuss current and potential implication of the mycobiome in clinical practice.
We performed a review of the existing literature in Medline Pubmed.
This review allowed us to identify several studies showing associations between specific mycobiome profiles and health. Fungi represents a significant biomass within the microbiota and several factors (like the microbiota) such diet, sex, age, comorbidities, medications, immune status and inter-kingdom interactions, can influence its structure and population. The human gut mycobiota is indeed a key-factor for several physiological (e.g. training of the immune system against infections) and pathological processes (e.g. immunological/inflammatory disorders, inflammatory bowel diseases, metabolic syndromes). Moreover, the mycobiome (and C. albicans in particular) could influence even a broader spectrum of conditions such as psychiatric diseases (e.g. depression, schizophrenia, bipolar disorder) or chronic viral infections (e.g. HIV, HBV); moreover, it could be implicated in tumorigenesis.
C. albicans is a well-known opportunistic pathogen and a major component of the mycobiome but its role in the GI tract is still poorly understood. From a potential screening biomarker to a key-factor for several pathological processes, its presence could influence or even modify our clinical practice in the next future.

Copyright © 2021. Published by Elsevier Ltd.